Katircioglu S Fehmi, Seren Mustafa, Parlar A Ihsan, Turan Nilufer N, Manavbasi Yasemin, Aydog Gulden, Cicekcioglu Ferit, Tutun Ufuk, Ulus A Tulga
Cardiovascular Surgery Clinic, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey.
J Card Surg. 2008 Jan-Feb;23(1):44-8. doi: 10.1111/j.1540-8191.2007.00486.x.
The new calcium sensitizer, levosimendan, not only acts as a positive inotropic agent but also, vasodilates both venules and arterioles. The aim of this experimental study was to investigate whether levosimendan has protective effects on spinal cord ischemia-reperfusion injury.
Twelve New Zealand rabbits were enrolled in this study. In addition to the control group, levosimendan is administered to the experimental group with a loading dose of 12 microg/kg prior to ischemia over a 10-minute period, followed by an infusion of 0.2 microg/kg/min during the ischemia period (30-minutes). Following the neurologic evaluation at the 24th hour of reperfusion, lumbar spinal cords were removed in order to perform microscopic examination and malondialdehyde (MDA) and myeloperoxidase (MPO) measurements.
The mean Tarlov score of the levosimendan group (3.25) was higher than the control group (0.7) (p< 0.05). MDA level was found significantly lower in the levosimendan group when compared with the control group as 1.6 +/- 0.4 nmol/gr and 189.3 +/- 43.6 nmol/gr respectively (p < 0.05). MPO level was also found statistically significant when we compared levosimendan group with the control group. It was calculated as 11.3 +/- 1.0 micro/gr tissue and 39.1 +/- 16.9 micro/gr in the levosimendan and the control groups (p< 0.05). Light microscopic examination was carried out with tissue samples in the 24th hour of the reperfusion. Levosimendan group had better preservation with the microscopic appearance with respect to the control group.
Levosimendan exhibits an important protection by means of neurological outcome, histopathological, and biochemical analysis for the ischemia-reperfusion injury of the spinal cord following the aortic clamping.
新型钙增敏剂左西孟旦不仅可作为正性肌力药物，还能使小静脉和小动脉扩张。本实验研究的目的是探讨左西孟旦对脊髓缺血再灌注损伤是否具有保护作用。
本研究纳入12只新西兰兔。除对照组外，实验组在缺血前10分钟给予12微克/千克的负荷剂量左西孟旦，随后在缺血期（30分钟）以0.2微克/千克/分钟的速度输注。在再灌注24小时进行神经学评估后，取出腰段脊髓以进行显微镜检查以及丙二醛（MDA）和髓过氧化物酶（MPO）测量。
左西孟旦组的平均塔尔洛夫评分（3.25）高于对照组（0.7）（p<0.05）。左西孟旦组的MDA水平明显低于对照组，分别为1.6±0.4纳摩尔/克和189.3±43.6纳摩尔/克（p<0.05）。当我们将左西孟旦组与对照组进行比较时，MPO水平也具有统计学意义。左西孟旦组和对照组的MPO水平分别计算为11.3±1.0微单位/克组织和39.1±16.9微单位/克（p<0.05）。在再灌注24小时对组织样本进行了光镜检查。与对照组相比，左西孟旦组在显微镜下的外观保存更好。
通过神经学结果、组织病理学和生化分析，左西孟旦对主动脉阻断后脊髓的缺血再灌注损伤表现出重要的保护作用。
